Erik Middlebrooks, MD
@EMiddlebrooksMD
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Professor & Assoc Chair @MayoClinic,Consultant Neuroradiology & Neurosurgery. President @theSENRS. Secretary @theASFNR. Senior Editor @theAJNR. Husband & Dad x4
Joined June 2019
Ok, people wanted more brain candy so here are better views of #7T CE-MRV at 300 micron isotropic resolution. #MayoClinicFlorida @SiemensHealth #Terra
MR CE Venogram on 3T compared to 7T @SiemensHealth Terra. #NeuroRad #neurotwitter #Neurology #radres #medtwitter
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MR CE Venogram on 3T compared to 7T @SiemensHealth Terra. #NeuroRad #neurotwitter #Neurology #radres #medtwitter
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Excited to share my approval of promotion to Professor in @MayoClinicSOM! Becoming youngest Professor in my department at a school that didn't offer me an interview as a pre-med is proof you don't have to be smartest, just willing to work hardest and not afraid to fail! 1/.
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Check out our 11.7T MRI of the midbrain at 100 micrometer resolution! Full publication on DBS targeting to be released soon in @NeurosurgeryCNS! @MayoRadiology @UFMDC @TheASNR @theASFNR #MedEd #NeuroRad #DBS @KDFooteMD @MichaelOkun @van_mila
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Impressive how well the anterior nucleus of thalamus can be seen on T2 SPACE with right parameters at #7T MRI…also impressive how asymmetric in position in this case!! 🪦 R.I.P. indirect #DBS targeting! 🪦 .#epilepsy #MayoClinicFlorida @MayoRadiology #Terra @SiemensHealth
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Taking the art of Dr. Rhoton to the next level of 3D using photogrammetry of dissections for DBS targets! The full atlas can be freely accessed at:
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While there is a DDx for this tiny lesion on 3T SWI in this #epilepsy patient, #7T T2* leaves little doubt in the diagnosis! #MayoClinicFlorida @MayoRadiology
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#DBS targeting has made monumental leaps with #7T MRI. Our newest pre-DBS sequence done in a #Parkinsons patient undergoing GPi DBS—0.5mm isotropic in less than 10 mins showing exquisite subcortical anatomy! #MayoClinicFlorida #Neurosurgery @MayoRadiology @SeizureSurgeon
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Combining the power of #7T with #AI k-space reconstruction for exquisite evaluation of hippocampal structure at 0.2 x 0.2 x 1.2 mm! #MayoClinicFlorida #epilepsy @MayoClinic @SiemensHealth @SiemensHealthPR
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Central vein sign is a powerful biomarker for #MS. Excited to share largest study to date on CVS at 7T & comparison with 3T! CVS detected in 87% of all lesions at 7T vs only 31% at 3T! 7T also 100% sens/spec for #MS diagnosis.@OkromelidzeLela @TheAJNR .
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Excited to start next part of my journey as Associate Chair at #MayoClinicFlorida! Our teams have been leaders in translation of state-of-the-art clinical imaging & I’m excited to help them build a grand vision for the future with our awesome Chair, @CandiceBolanMd!.
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At #MayoClinicFlorida, we are excited to celebrate over 1000 clinical #7T scans! 🎉 After reviewing all 1000, I remain blown away at the number of diagnoses made or changed for our patients—and we’ve only scratched the surface! A superb & experienced team is critical to success!
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An immense honor to win 2024 Minnie Award for Most Influential Radiology Researcher! Credit goes to my amazing team, research fellows, & #NeuroRad colleagues! Thank you to @AuntMinnie for the thorough work to honor advancements & achievements in our field!.
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3D-EDGE at 7T with 0.4 mm isotropic resolution is stunning! And easily paired with 0.4 mm MP2RAGE to maximize detection of subtle dysplasia! @SiemensHealth #Terra @MayoRadiology #MayoClinicFlorida #epilepsy
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Isn’t the hippocampus a beautiful thing? I mean, it is almost as fascinating as the thalamus! #hippocampus #NeuroTwitter #epilepsy
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7-T MRI: Providing Hope by Seeing the Previously Unseen.#MayoClinicFlorida #NeuroRad #NeuroTwitter .@MayoClinic @MayoRadiology .
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Vowed to avoid “post-Professor” apathy by publishing 52 articles (1/week) in Year 1 after promotion. Only 46 released, but had #52 accepted just in time! Counting it! Truth be told, it’s work of so many collaborators & mentees, which is even more meaningful to me! 🧵 1/4.
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I have seen this circulating a lot lately. It is very important that we acknowledge this IS NOT how language works! Even down to the fact that Broca area does not = Broca aphasia and Wernicke area does not = Wernicke aphasia! 1/4
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I’ve been fortunate in my career to have so many renowned mentors that have heavily influenced my path. It wasn’t by chance! Now as a mentor to others, I have a much better understanding of the do’s and don’ts of being a mentee. An opinion 🧵 on how I got my foot in door. 1/25.
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Big congratulations to @phudge54 for receiving the 2022 @TheASNR Gold Medal! Well deserved! We are fortunate to have you as part of our team and fellowship program at #MayoClinicFlorida! @MayoRadiology @MayoClinic @MayoClinicNeuro #NeuroRad
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So proud of my awesome research team for their publication that made the cover @TheAJNR! They never cease to amaze me with all they accomplish! @cyndlg @AyushixJain @SAliMontazeri @OkromelidzeLela . And thank you @TheAJNR & @TheASNR! @MayoRadiology @MayoClinic @MayoFL_RadRes
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A bittersweet day as I officially hand over #MayoClinicFlorida #NeuroRad fellowship to these incredible educators! @Alok_A_Bhatt will be PD and @AmitDesaiMD will be Assoc. PD! We have assembled a world class team of educators & trained some of most phenomenal fellows I have had
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Working on some @theASFNR programming material for #ASNR2021–I will try to disentangle this! Can’t wait to see all the exciting content this year! @TheASNR @MayoRadiology #NeuroRad #radres #neurotwitter
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Just doing some tinkering on #7T and liking this anatomy of STN and SN! Isotropic 0.3 mm resolution useful for STN targeting—with spin echo to reduce blooming of boundaries? SN pathology? 🤔#Parkinsons #DBS #neurotwitter #MayoClinicFlorida
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As a PD, I’m glad to have the support of my institution in providing for our trainees. @MayoClinic GME has now substantially increased trainee salary TWICE in just 6 month period! Important recognition of the hard work & dedication of our trainees during these challenging times!.
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@danmurrayserter Consider at least giving credit to the people who spent a great deal of time and effort to develop the images that you use without permission!.
Ok, people wanted more brain candy so here are better views of #7T CE-MRV at 300 micron isotropic resolution. #MayoClinicFlorida @SiemensHealth #Terra
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Excited to share our latest work on #brainmapping to explore role of uncinate fasciculus. Role of UF heavily debated. Using precision mapping & testing, we shed further light on its function. @DSabsevitzPhd @SeizureSurgeon @DoctorQMd #neurosurgery 1/5.
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First study exploring the impact of 7T vs 3T MRI on DBS outcomes for tremor: Our study shows 7T offers superior precision, improving tremor reduction & requiring lower stimulation current! @TheJNS @MayoRadiology #MayoClinicFlorida 🧵 .
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Excited to finally share real-world results of our translation of 3D EDGE to #7T MRI! 50% reduction in voxel volume still with ~2x SNR as 3T!! A powerful tool for FCD detection in #epilepsy that is easily integrated into existing sequences. @MayoRadiology.
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Radiologist responding to the code blue in MRI….
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Yes, but does your conference have this view in the main conference room? 🇵🇹 Thanks to @ChampalimaudF for hosting @ISMRM Ultra-High Field 2022! Beautiful campus! #7T #neurotwitter
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Happy to share another milestone of #MayoClinicFlorida 7T program—now having performed >2,000 clinical #7T exams! 500+ epilepsy evals, 600+ #MS patients, & many others! Amazed by how many patients’ lives changed already, but best is yet to come! More exciting news coming soon!
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Excited to share our latest work using synthetic image generation for common #DBS targeting sequences! From a single MP2RAGE acquisition, we can create T1, FGATIR, EDGE, GM nulled, etc. & also optimize image contrast. #neurotwitter #NeuroRad.
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New toy being installed in our #MayoClinicFlorida outpatient #neuroscience building—7T Terra! @SiemensHealth @MayoClinic @MayoRadiology @MayoClinicNeuro
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Excited to be @NIH to speak about #neuromodulation and hear about some of the most exciting cutting-edge science from around the world! First up, creating accurate models of current flow in the brain with Axel Thielscher! @ISMRM @MayoRadiology
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Great work by @paosmeade, @MarencoLina, & @OkromelidzeLela! Further evidence that “Broca” cortex is less critical than historically considered & often safely resected when underlying WM tracts spared. @kchaichanamd @DoctorQMd @EMiddlebrooksMD #neurotwitter.
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Yet another case showing superiority of EDGE in detecting the most subtle FCDs over other sequences including DIR! This case caught by @AmitAgarwalMD!.#7T #EDGE #MayoClinicFlorida #NeuroRad #Neurosurgery #epilepsy @SeizureSurgeon @MayoRadiology @MayoClinicNeuro
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Anyone ever eaten a Biscoff cookie while on the ground? ✈️ 🍪.
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@pipcosper As my mentor @MancusoMD once said to me: “If people readily accept your research, it probably isn’t that important or correct!” Bigger discovery=bigger skepticism. Its human nature to not easily accept things that go against all we’ve believed. Don’t let rejection slow you down!.
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It has been 10 years since I first had the opportunity of a lifetime to work with Prof. Rhoton’s lab for over 2 years—challenging me in ways I had never been, in an endless pursuit to find beauty & perfection in the brain. Relationships forged in this lab continue to this day
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We are super excited to welcome Vishal Patel, MD, PhD to #MayoClinicFlorida team as our newest #NeuroRad to further advance our Ultra-High Field MRI and #AI programs! @MayoRadiology @MayoClinicNeuro
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Interested in a post-doc position in #7T MRI starting 2023? High-volume 7T practice with ~1,000 clinical cases per year—great opportunities for 7T translation! 7T experience highly preferred or relevant background in neuroimaging analysis. Contact me if interested! #neuroimaging.
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Some clinical experiences using ultra-high res (300 micron) CS TOF MRA at #7T led by @dhairyalakhani 🎉 .Substantial gain in small vessel pathology with 7T (left images) vs 3T (right images).#MayoClinicFlorida @jsandhu11 @MayoRadiology @TheNeuroradJour.
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Thank you, @AuntMinnie, for this humbling recognition! I’m fortunate to have tremendous support from @MayoClinic & a world-class research team that constantly challenges me. Most important thing I’ve learned is to surround yourself with people who share your ambition & vision!
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Seems like not so long ago I joined this exciting ride with a group of people determined to push #MayoClinicFlorida to the forefront of neuroscience! Mission not over, but proud of all that has happened in my 5 years! A great team @jmarkdoc @KentThielen @DoctorQMd @MayoClinic
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Reviewing year-end data and proud to see that we have nearly 700 clinical 7T scans over past year at #MayoClinicFlorida! So many changed diagnoses and new options for patients! And also a rapidly growing and amazing 7T team with 3 new faculty members! @MayoClinic.
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Sometimes the only way to end a long, busy week is to just dance! Happy Father’s Day to all the great dads out there! #DaddyDaughterDance #FathersDay2021 #Princess
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Patients with prominent hippocampal dentation are subject to volume averaging even in high res 3T COR T2, as in this case, that led to concern over loss of architecture. Ultra-high res T2 at #7T is able to easily resolve this as normal. #MayoClinicFlorida #NeuroRad #Epilepsy
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Many have asked about the sequence, this is an optimized 3D FLASH with 300 x 300 x 300 micron voxel size and acquisition time is 2 min 15 sec. Used a @SiemensHealth Terra 7T with Nova 8/32 transmit/receive coil. And yes, this is just our routine clinic contrast-enhanced MRV!.
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#7T MRI a powerful tool in diagnosis of #PD, allowing high res evaluation of substantia nigra in vivo. A patient with severe right upper & lower extremity #Parkinsonism shows asymmetric reduction in neuromelanin w/ increased iron deposition in left nigrosome 1. #MayoClinicFlorida
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Honored to work with such an outstanding team on this project! A single tract was predictive of outcome in ET DBS in 2 cohorts & unifies variations in previously reported “sweet spots.” @MayoRadiology @FixelInstitute @leaddbs #Neurosurgery #NeuroRad #DBS.
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Today marks 13 years! Truly my better half—the most patient, kindest, selfless, and smartest person I know and daily reminder to be better! #anniversary #ValentinesDay
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Happy #Halloween!! 🎃 .I surprised my daughter this year by dressing up to match her theme!. My most elaborate costume but I will be picking spirit gum out of my beard until retirement!
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What I try to teach mentees about abstracts:.1) Don’t waste time on abstract that is unlikely to yield a publication. 2) Write the paper draft then copy and submit abstract. If you do the opposite order, >85% chance you won’t do the paper based on review of many CVs!. 3) Don’t.
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Not sure I am deserving of being included with such amazing members, but honored to have chance to support #TheCortexClub and the amazing work done by @MohitAgNeurorad in raising education and interest in #neuroradiology! And great work by his daughter in design and packaging!
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Hanging out with the legend and @theASFNR President @hsairmd trying to absorb as much about rs-fMRI, life, and leadership from the master! I gave some tips on 🥩, but that is all I can teach him! .🇦🇷 #BuenosAires 🇦🇷
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Honored for the opportunity to spend the day visiting @MGHImaging @harvardmed today to discuss #7T imaging and many other hot topics! Amazing faculty doing a lot of great things! Not to mention a very entertaining group! 🧠
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Too often I hear that #NeuroRad job in neurodegenerative disease is to “rule out tumors and strokes.” Don’t sell yourself short! We can make a major difference in the care of these patients! Missed clinical and imaging diagnosis can lead to incorrect prognosis and treatment!
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A game changer in our #epilepsy practice! Better contrast for the more apparent Type II FCDs, but more importantly, far more sensitive to elusive Type I FCD. T2 approaches, like FLAIR & DIR, offer little gain in Type I which lack balloon cells & dysmorphic neurons that give T2.
"Edge-Enhancing Gradient-Echo MP2RAGE for Clinical Epilepsy Imaging at 7T" #epilepsy #7TMRI @theASFNR |
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The precision of routine 7T #fmri is quite impressive! Still haven’t broken it—so have a ways left to “improve” 😆.#MayoClinicFlorida @MayoClinicNeuro @MayoRadiology #7T #NeuroRad
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New to functional imaging or just want to learn more about brain functional anatomy? Check out this overview of some key functional anatomy coauthored with #fmri expert Behroze Vachha! @RadClinics @MSKCancerCenter @MayoRadiology #RadRes #NeuroRad.
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#fmri is routinely used in pre-surgical mapping for tumors & lots of optimism, but what is the ACTUAL evidence for fMRI? You might be surprised! Check out our review by @dhairyalakhani on what we do & do not know! @radiology_rsna @MayoRadiology .
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Congratulations to @Alok_A_Bhatt on yet another education award! He is a tremendous asset to our #NeuroRad fellowship and @MayoFL_RadRes! We are running out of awards to give him…
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Deeply honored for opportunity to share stage in Shanghai with so many pioneers of MRI—Kamil Ugurbil, Seong-Gi Kim, @dannywang, & more! Never been more excited about the future of neuroimaging! #NeuroRad #7T
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@RogueRad I’m going to say it. ”AI” in radiology has probably helped academic careers far more than it has helped patients!.
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Amazing detection of fiber orientations through this glioma corresponding to expected anatomy using GQI and grid sampling scheme. Credit to collaboration with @FangChengYeh, a true ‘Michelangelo’ of tractography! #tractography #neurosurgery #MayoClinicFlorida @MayoRadiology
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We are thrilled to expand advanced imaging capabilities to our patients at #MayoClinicFlorida with installation of the first FDA-approved 7 Tesla MRI in Florida! Such an awesome engineering feat to witness! @MayoRadiology @MayoClinicNeuro @MayoFL_RadRes .
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One of the most amazing sunsets I have ever seen! Camera just doesn’t quite capture the pink to blue hues over the fall mountain colors!
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Looking forward to joining @SiemensHealth in Germany to discuss exciting developments in #7T MRI! Many great things on the horizon and we are so excited about new areas of impact in our clinical practice!
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Dr. Wintermark (@theAJNR_EIC) is a model leader—a prolific academician who is never too important to speak to anyone or listen to their opinion & promotes career of others. One of many leaders that make #NeuroRad the best specialty! @TheASNR @theASFNR @TheAJNR @MDAndersonNews.
What an incredible honor to meet Dr. Max Wintermark, Editor-in-Chief of @TheAJNR! His expertise and dedication to advancing the field of #neuroradiology are truly inspiring. #ASNR23
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Great experience partnering with 🚀 AX-1 mission crew @CommanderMLA and Pilot Larry Connor at #MayoClinicFlorida! Excited to see the great things coming from @Axiom_Space in the future—a fantastic company! @MayoRadiology
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A nice surprise gift of gratitude arrived today from @MayoClinic! Items representing all of our campuses from Midwest, Florida, Arizona, London, and Abu Dhabi! Grateful to have an employer that looks after employees in these difficult times! #MayoClinicFlorida
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Congratulations to @jsandhu11, our new #MayoClinicFlorida Neuroradiology Division Chief! 🥳 Big shoes to fill after Vivek Gupta did amazing job building education & innovation powerhouse during his term, but no doubt Dr. Sandhu will lead us to more great things! @MayoRadiology.
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Excited to offer 2 post-doc positions at #MayoClinicFlorida Radiology! Particularly seeking candidates with expertise in ultra-high field MRI, radiochemistry, AI, or quantitative & functional neuroimaging. More details and application below! @MayoClinic .
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Very excited about our new toy being installed now at #MayoClinicFlorida! Grateful to @SiemensHealth for our amazing ongoing & future collaborations in #7T MRI! The future is bright for clinical 7T! @MayoClinic @MayoRadiology #NeuroRad
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Don’t fall victim to satisfaction of search (or my biggest pet peeve, the epidemic overdiagnosis of “NPH)!
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Exciting work on photon-counting CT with my colleague John Murray for assessing direction electrodes! Reliance on streak artifact from electrodes is challenging with multiple electrodes—why not just directly reconstruct the electrode?! Amazed by advantages of photon CT!
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Great to have Dr. Mikulis & Dr. Fisher join us for launch of our #7T RespirAct system, first 7T install in North America! Another milestone for our 7T program that will allow unprecedented exploration of cerebrovascular physiology & pathology at #MayoClinicFlorida! @MayoRadiology
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On my way to Germany ✈️ and who do I run into in the nation’s capital? None other than the boss and legend himself @DoctorQMd! #MayoClinicFlorida 🧠
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Honored to be selected as a finalist for the 2023 Top Images in @radiology_rsna with @AmitDesaiMD for work on ultra-high res 7T MRA with compressed sensing! Thank you to the awesome @radiology_rsna In Training Editors! #MayoClinicFlorida #NeuroRad.
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Thank you so much @UCSFimaging for this kind and thoughtful gift! Was an honor to join you! @CMGlastonbury @vinil_shah @NeuroDx @YiLiMD @PratikMukhMDPHD @BhavyaRehaniMD @LizzRad @UCSF @MayoRadiology
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Check out our new article in @Brain1878 showing added benefit of pallidothalamic stimulation in #DBS for dystonic tremor compared to essential tremor! @MayoRadiology @UFMDC @RobertSEisinger @MichaelOkun @KDFooteMD @OkromelidzeLela @SeizureSurgeon .
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7T neuromelanin imaging for diagnosis of #ParkinsonsDisease now available! 7T NM imaging is a highly accurate biomarker for PD. @dhairyalakhani has done a great job with this project! A few key observations. @Nature @MayoRadiology .
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Kicking off our 7T Summit Meeting at #MayoClinicFlorida to review many amazing success stories of past year, updates on new development projects, and planning the future of clinical 7T! @MayoRadiology @MayoClinicNeuro @jsandhu11 @VishalPatel_MD
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